Sepsis: definition, symptoms, causes, and treatment

Definition of sepsis

Sepsis is extreme inflammation due to a potentially life-threatening infection. Sepsis occurs when an infection in your body triggers other infections throughout your body. This occurs when the immune system overreacts by releasing chemicals into the blood vessels to fight infection with disease-causing microorganisms.

Sepsis can occur due to septicemia, aka blood poisoning, which is a condition when a bacterial infection has invaded the bloodstream. Some infectious diseases that can trigger this reaction are urinary tract infections, surgical wound infections, pneumonia, meningitis including COVID-19.

Inflammation due to sepsis risks causing blockage and leakage of blood vessels. In this condition, sepsis can damage various organ systems and even cause organ failure.

If you develop septic shock, your blood pressure will drop dramatically. At this stage, sepsis can cause death.

How common is this condition?

When contracting an infectious disease, older adults, people with weak immune systems or congenital diseases, pregnant women, and babies under 1 year of age are more at risk of developing sepsis. However, this condition can also affect patients of all ages.

Sepsis can also occur while you are recovering in the hospital, but it does not occur in all cases. This disease can be overcome by reducing several risk factors that trigger the immune system to overreact to infection.

Symptoms of sepsis

Based on the severity of the symptoms, sepsis can be divided into symptoms of sepsis, severe sepsis, and septic shock.

It is important to seek medical attention immediately if you experience any of the following symptoms of sepsis. Recognize well the signs of sepsis because the sooner it is treated, the higher the chances of preventing septic shock from occurring.

Symptoms of sepsis

Initially, sepsis will enter a stage Systemic Inflammatory Response Syndrome (SIRS). The early symptoms of sepsis are characterized by two or more health problems, including:

• Fever
• Sweating
• Hypothermia (body temperature is too low)
• Pulse too fast
• Breath rate too fast
• Changes in the number of blood leukocytes

Medically, the signs of a patient experiencing sepsis can be known through:

• Systolic blood pressure (first / upper number) is less than or equal to 100 mmHg.
• Respiratory rate higher or equal to 22 breaths per minute.
• Body temperature above 38.3 ℃ or below 36 ℃

Symptoms of severe sepsis

If infection in the bloodstream continues, organ damage may occur. This is because the infection that occurs makes the organs lack oxygen supply.

In this condition, the severity of the symptoms of sepsis will be more serious and require medical attention. Symptoms include:

• Red patches or rash
• The skin changes color
• Urine production is drastically reduced
• Sudden change in psychiatric status
• Decreased platelet count
• Difficulty breathing
• Abnormal heart rate
• Stomach ache
• Unconsciousness
• Extreme weakness

Symptoms of septic shock

More severe conditions can develop into septic shock, which can lead to death. Septic shock indicates a serious disturbance in the circulatory system and metabolism of body cells. This condition is mainly characterized by decreased blood pressure.

According to the Mayo Clinic, some of the symptoms and signs of septic shock include:

• Blood pressure is so low that you have to take medication to keep your blood pressure higher than or equal to 65 mm Hg.
• High levels of lactic acid in the blood (serum lactate) after receiving adequate fluid replacement. Having too much lactic acid in the blood means your cells don't use oxygen properly.

When to go to the doctor

Sepsis conditions generally occur in patients who are in intensive care in the hospital due to infectious diseases. Sepsis occurs as a result of the development of an infectious disease that is experienced.

However, this condition can also be experienced due to postoperative wound infection. If you experience signs and symptoms of sepsis after being treated or having surgery in the hospital, seek medical attention immediately.

Causes of sepsis

The cause of sepsis is a bacterial, viral, or fungal infection that triggers the immune system to act uncontrollably to fight the infection. This condition causes inflammation to spread to the blood vessels and results in constriction and leakage.

According to the National Institute of General Medical Science, sepsis can result from an infection that takes place in the lungs, kidneys, or digestive tract.

All infectious diseases have the potential to cause sepsis. However, certain infectious diseases and conditions that most often lead to the spread of infection to the bloodstream are:

• Pneumonia and other lung infections
• Intestinal and gastrointestinal infections
• Surgical wound infection
• Urinary tract infection
• Infections of the kidneys
• Infection of blood vessels by bacteria (septicemia)

Other causes include a weakened immune system that can be caused by diseases such as HIV, cancer treatments or organ transplant drugs, and increasing age.

In addition, bacteria that are resistant to antibiotics can also cause sepsis. This often occurs due to the indiscriminate consumption of antibiotics so that bacterial infections are no longer effective in being treated with antibiotics.

Risk factors

There are some infectious disease patients who are hospitalized at a higher risk of developing this condition. The factors that can trigger sepsis include:

• Are less than one year old, especially if the baby was born prematurely or the mother contracted an infection during pregnancy.
• Are over 75 years of age.
• Have diabetes or cirrhosis (liver damage).
• Inpatient in ICU
• Have a weak immune system, such as those who are going through chemotherapy treatment or who have recently had an organ transplant.
• Recently had a child or had a miscarriage.
• Have a wound or injury, for example a burn.
• Have an invasive device, such as an intravenous catheter or a breathing tube.

Risk factors in newborns

Neonatal sepsis occurs when a baby develops a bloodstream infection in the early months of life. This condition is divided according to the time of infection, whether the infection is contracted during the birth process or after birth.

Low birth weight and premature babies are more susceptible to this condition because of their immature immune system.

This condition is still the main cause of death in infants. However, with early diagnosis and treatment, the baby will recover and have no other health problems.

Risk factors in the elderly

Since the human body's immune system declines with age, Lanisa can also develop this infection.

In addition, chronic diseases, such as diabetes, kidney disease, cancer, high blood pressure, and HIV, are common in those with sepsis.

The most common types of infections that cause the condition in the elderly are respiratory problems, such as pneumonia, or genitourinary, such as urinary tract infections.

Other infections can occur with skin that is infected due to pressure sores or tearing of the skin. Confusion or disorientation are common symptoms to watch for when identifying infection in the elderly.

Complications

Severe sepsis and septic shock can also lead to complications. The most serious complication of sepsis is death. The death rate from septic shock is 50 percent of all cases.

Small blood clots can form all over your body. These clots block the flow of blood and oxygen to vital organs and other parts of your body. This increases the risk of organ failure and tissue death.

Although potentially life-threatening, in mild cases, the recovery rate can be higher. However, patients who survive severe septic shock are at higher risk of developing infectious diseases in the future.

Diagnosis

Your doctor will need tests to determine if you have sepsis and identify the severity of the infection. The tests to diagnose sepsis are:

1. Blood test

A blood test may be the first step you need. Blood test results can provide information, such as:

• Infectious conditions, blockage problems, abnormal liver or kidney function.
• Oxygen levels and electrolyte imbalances in the body as well as the acidity of the blood.

2. Imaging tests

If the location of the infection is not clear, your doctor may order imaging tests, such as the following:

• X-ray to see the lungs.
• Computed tomography (CT) scan to look for possible infection in the appendix, pancreas, or intestinal area.
• Ultrasound to look for infections in the bladder or ovaries.
• Magnetic resonance imaging (MRI)What can identify a soft tissue infection is what can be done if the above tests are unable to help find the source of the infection.

3. Other laboratory tests

Depending on your symptoms, your doctor may ask you to do other tests, including:

• Urine test
  This test is done if the doctor suspects a urinary tract infection. In addition, this test is also performed to check whether there are bacteria in the urine.
• Wound secretions
  If you have a wound that is suspected of infection, testing a sample of wound secretions can help show which type of antibiotic works best.
• Respiratory secretions
  If you cough up mucus (sputum), you may be tested to determine what type of germ is causing the infection.

Sepsis treatment

The information provided is not a substitute for medical advice. ALWAYS consult your health condition to the doctor.

Early treatment can increase your chances of surviving the condition. People who experience this condition require close monitoring and care in the hospital's intensive care unit.

If you have sepsis or septic shock, life-saving measures may be needed to stabilize respiratory and heart function.

Some medications that can help treat sepsis are:

1. Antibiotics

If you detect sepsis at an early stage, when the vital organs haven't been affected, you can use antibiotics to treat it at home. In this situation, it is possible to fully recover.

However, if you don't undergo any treatment, this condition can progress to septic shock and even lead to death eventually. In this case, doctors usually use a number of drugs to treat sepsis.

2. Intravenous fluids

Drugs can be in the form of intravenous antibiotics to fight infection, drugs vasoactive to increase blood pressure, insulin to stabilize blood sugar, corticosteroids to reduce inflammation, and painkillers.

If sepsis becomes severe, it is important to have large amounts of intravenous fluids and a breathing respirator.

3. Dialysis

Dialysis may be needed if the kidneys are getting affected. During dialysis, machines replace kidney functions such as filtering harmful waste, salt, and excess water from the blood.

4. Operation

In some cases, surgery may be needed to remove the source of infection, including absorption of a purulent abscess or removal of infected tissue.

Some other medications that may be recommended are low doses of corticosteroids, insulin to help maintain stable blood sugar levels, drugs that modify the immune system's response, and painkillers or sedatives.

Home remedies

Most of the people fully recover from this condition. However, it will take time. You may continue to experience physical and emotional symptoms. This can happen for months or even years.

This situation is called post-sepsis syndrome or the syndrome after sepsis. The symptoms are:

• Feeling tired and weak, and having trouble sleeping
• Loss of appetite
• Get sick more often
• Changes in your mood, such as anxiety and depression
• Nightmare

What lifestyle changes can I make?

The lifestyles that may aid recovery from sepsis are:

• Living a healthy lifestyle can help reduce the risk of developing an infection.
• Quit smoking and drinking alcohol.
• Get vaccinated against flu, pneumonia, and other infections regularly.
• Maintain cleanliness. This means trying to do wound care, washing your hands, and showering regularly.

Seek treatment immediately if you develop signs of infection. Every minute counts when you are having sepsis treatment. The sooner you are handled, the better the results.